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KN JD NPTE: MSK/NM > MSK Pediatric Orthopedic Conditions > Flashcards

MSK Pediatric Orthopedic Conditions Flashcards

1
Q

Thigh-foot angle

How to measure/what is it

A

Angle between axis of foot and axis of thigh measured with child prone and knees at 90 flexion —> describes degrees of TIBIAL torsion

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2
Q

3 causes of toeing-in

A

Metatarsus adductus
Internal tibial torsion
Increased femoral anteversion

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3
Q

What is metatarsus adductus, what are the 2 types

A

most common congenital foot deformity

1) rigid: medial subluxation of TMT it’s hindfoot slightly in valgus, navicular lateral to head of talus
2) flexible: adduction of all 5 metatarsals at TMT joint

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4
Q

What is surgical option for flexible metatarsus adductus

A

Release of abductor hallucinations tendon

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5
Q

Femoral anteversion is excessive if (degrees)

A

> 25 from frontal plane

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6
Q

Femoral retroversion is excessive if (degrees)

A

<10 from frontal plane

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7
Q

Toeing out is caused by

A

Femoral retroversion, external tibial torsion, flat feet

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8
Q 
Talipes equinovarus (aka \_\_\_\_) occurs from what?
What does deformity look like?
A

Clubfoot- postural rom intrauterine malposition
Abnormal dev of talar head/neck
Observation: PF, addicted, inverted foot (postural)

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9
Q

PT Tx for postural talipes equinovarus

A
  • manipulation followed by casting/splinting (Ponseti method)
  • following casting, stretching
  • Denis-Browne splint orthoses throughout day for 3 months, at night up to 3 years
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10
Q

Tx for Talipes equinovarus NON-postural

A

Surgical intervention followed by casting/splinting

Achilles tenotomy may be needed

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11
Q

Genu ___ is normal in newborn and infants

A

Varum

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12
Q

Maximal varum present at ____ (age)

A

6-12 months

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13
Q

Lower limbs begin to straighten with zero tibiofemoral angle by ______ (age)

A

18-24 months

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14
Q

Knees gradually drift into valgus and is maximal around ____ (age) with average medial tibiofemoral angle of ____ degrees

A

3-4 yrs

12 degrees

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15
Q

Genu valgum spontaneously corrects by age ___ to adult alignment of lower limbs

A

7 yrs

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16
Q

__ of valgum in females and ___ in males (degrees)

A

8, 7

17
Q

Hip Dysplasia Risk Factors

A 
females > males
Breech position
Family history
Low levels of amniotic fluid
Swaddling infant too tight
18
Q

Hip dysplasia clinical exam (5)

A 
Ortolani test
Barlow test
Klisic sign
Galeazzi sign
Limited hip abduction
19
Q

Hip dysplasia tx

A

1) Pavlik harness is gold standard- Maintains hip in flexion and abduction to keep head of femur in acetabulum (newborn-6mo)
2) Closed reduction under anesthesia followed by SPICA cast for 12 weeks for children 6 mo-2 yrs
3) Open reduction under anesthesia followed by spica cas 6-12 wks for children >2yrs

20
Q

Transient synovitis- what is it? What are s/sx?

A

Acute onset of hip pain children 3-10 yrs old, transient inflammation of synovium of hip
1) U/L hip/groin pain 2) med thigh/knee pain 3) crying at night 4) antalgic limp 5) pain not common 6) recent upper respiratory tract infection

Lasts 7-10 days

21
Q

What is legg-calve perthes disease? Age/male vs female?

A

Interruption of blood supply to femoral head

2-13 yo, 4x greater incidence males > females

22
Q

Dx test and result for legg-calve perthes disease

A

MRI showing positiv bony crescent sign

23
Q

Clinical exam findings for legg-calve perthes disease and tx

A
  1. Characteristic psoatic limp due to psoas weakness, moves in ER/flexion/adduction
  2. Gradual onset hip/thigh/knee aching
  3. AROM limited in abduction and extension

Tx: cast 4-6 weeks, surgery if necessary

24
Q

SCFE - what is it, how old, male vs female, limitations seen

A 
fem head displaced posterior/inferior
Males 10-17 yo, females 8-15 yo
Males 2x > females
AROM limited flexion, abduction, IR
vague hip/thigh/knee pain (maybe trendelenburg gait)
Requires ORIF
25
Q

Tendon lengthening conditions

A

Osgood-schlatter disease
Sever’s disease
Sinding-Larsen Johannson’s disease

26
Q

What is Sinding-Larsen Johannson’s Disease

A

Traction apophysitis at patella-patellar tendon junction

27
Q

Osteochondritis dessicans

A

Separation of articular cartilage from underlying bone (usually medial femoral condyle)
-Osteochondral bone fragment becomes detached from articular surface forming loose bod in joint

28
Q

Panner’s disease

A

Localized AVN of capitellum leading to loss of subchondral bone with fissuring and softening of articular surfaces of radiocapitellar joint (children 10 and younger)

29
Q 
Pes planus (flat foot)
Normal in infant and toddler feet and develop normal arches around \_\_\_\_ (age)
A

2-3 years

30
Q

Pes planus leads to decreased ability of foot to provide _____ ____ for push off during gait

A

Rigid lever

31
Q

Structural vs non-structural scoliosis

A

Structural: irreversible lateral curve with rotational component
Non-structural: reversible lateral curve without rotational component and straightens with flexion of spine

32
Q

Tx for scoliosis (conservative, bracing, surgery)

A

Conservative: <25 degree curve
Bracing: 25-45 degree curve
Surgery with Harrington rod: >45 degree curve

33
Q

Scoliosis direction named for (convex/concave)

A

CONCAVITY

34
Q

Arthrogryposis multiplex congenita

A

Congenital deformity of skeleton and soft tissues, characterized by limitation in joint motion and “sausage like” appearance of limbs

  1. Non-progressive contractures
  2. Intelligence develops normally
35
Q

OI inherited disorder transmitted by

A

Autosomal dominant gene

36
Q

What is OI

A
  1. Abnormal collagen synthesis — imbalance between bone deposition and reabsorption
  2. Cortical and cancellous bones become very thin —> fractures/deformity
37
Q

Spondylolisthesis

A

Congenitally defective pars interarticularis

Anterior or posterior slippage of one vertebra on another following bilateral fx of pars

38
Q

Spondylolysthesis grades

A

1 (25% slippage) to 4 (100% slippage)

39
Q

Spondylolysis

A

Fx of pars with positive “Scotty dog” on oblique x-ray of spine

KN JD NPTE: MSK/NM (35 decks)

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